Ohio may expand Medicaid this year

Ohio’s Republican governor, John Kasich, was in good company last winter when he proposed expanding his state’s Medicaid program through Obamacare. Like Arizona’s Jan Brewer, New Jersey’s Chris Christie and Michigan’s Rick Snyder, he realized he couldn’t reasonably refuse basic health care to hundreds of thousands of struggling constituents if the feds would foot the bill. Kasich hit a wall when took his idea to the legislature—his fellow Republicans killed it in committee—but he didn’t give up. “I believe it’s a matter of life and death,” he told the Cincinnati Enquirer in July. “It’s going to happen. It’s just a matter of when.”

The answer may be Oct. 21—a date that would enable thousands of uninsured Ohioans to start coverage on Jan. 1. Federal health officials formally approved the Kasich administration’s expansion proposal this week—and on Friday the governor announced he would sidestep the legislature in order to move the plan forward.

Rather than return to the state general assembly, Kasich is asking Ohio’s seven-member “controlling board” to release the nearly $3 billion the federal government has promised the state for 2014 and 2015.

Kasich contends that the board—composed of six legislators and a representative of the governor’s office—can legally clear state agencies to spend federal funds. And political observers assume he has the votes lined up. “I don’t think he would take this step without consulting the house speaker and the senate president,” says Barbara Sears, a Republican representative who is still pushing an expansion bill in her chamber.

Despite its sudden death in a House committee last spring, the expansion measure enjoys broad public support in Ohio. Business leaders, religious leaders and health care providers have been as vocal progressives. But Republican lawmakers have lain low, knowing their support could attract nationally funded Tea Party primary challenges.

On its merits, the expansion is a no-brainer for Ohio. In an analysis published in March, the Policy Institute of Ohio Estimated it would create 23,000 jobs by 2015 and save the state $1.4 billion by 2022. Best of all, it could bring primary health care to 450,000 low-income Ohioans who don’t currently qualify for Medicaid.

“I sat down yesterday with a couple who’d had insurance all their lives until one of them lost a job,” says Cathy Levine, co-chair of Ohio Consumers for Health Coverage.“They’renot parents and not disabled, so they had no options. Now at least they have hope.”